Hyperglycemia, or high blood sugar, reflects an abnormality in the utilization and storage of glucose. The pancreas normally produces and secretes insulin into the circulation when the blood sugar begins rising, preventing hyperglycemia. The overwhelming majority of people with persistent hyperglycemia have diabetes mellitus or pre-diabetes caused by insufficient insulin production or resistance to its actions.
Diagnosis
Hyperglycemia is diagnosed by measuring the amount of sugar, or glucose, in the blood. A fasting blood glucose remains the most common test for diabetes and pre-diabetes, reports the National Institute of Diabetes and Digestive and Kidney Diseases, or NIDDK. After an overnight fast of at least eight hours, the client reports to the testing laboratory in the morning to have a fasting blood glucose drawn before eating or drinking. A fasting blood glucose level of 126 mg/dL or more on two different occasions is diagnostic for diabetes mellitus, reports NIDDK. A level of 100 to 125 mg/dL represents pre-diabetes, a condition of impaired glucose utilization and storage that can lead to type 2 diabetes.
Significance
Nearly 8 percent of the adult population in the United States--23.5 million Americans older than age 19--had diabetes as of 2007, according to NIDDK. An estimated 57 million additional Americans had pre-diabetes in the same time frame. Diabetes remains a leading cause of death among Americans, according to the Centers for Disease Control and Prevention.
Effects
Chronic hyperglycemia associated with diabetes significantly increases the risk for heart disease, kidney failure, poor circulation, stroke, nerve disorders, vision problems and amputations, notes the medical reference text "Harrison's Principles of Internal Medicine." The long-term complications of diabetes arise because of the adverse effects of hyperglycemia on the blood vessels, note Dr. Gabriela Orasanu and Dr. Jorge Plutzky in a February 2009 article published in the "Journal of the American College of Cardiology."
Blood vessel-related heart and kidney disease remain among the most common causes of diabetes-associated deaths. The American Heart Association reports that people with diabetes mellitus have a 2- to 4-fold increased risk for cardiovascular disease compared to people without diabetes. Diabetes is also the leading cause of kidney disease, reports the National Kidney Foundation. Approximately 33 percent of diabetics develops chronic kidney disease.
Prevention
Up to 95 percent of American diabetics have type 2 diabetes, according to NIDDK. Excess body weight and obesity are strongly linked to pre-diabetes and type 2 diabetes. Maintaining a healthy body weight reduces the risk for these conditions. Among people with pre-diabetes, the risk of developing type 2 diabetes decreases by nearly 60 percent with regular exercise and modest weight loss, report Dr. William Knowler and colleagues in a hallmark 2002 study published in "The New England Journal of Medicine."
Treatment
Treatment for hyperglycemia focuses on maintaining a normal or near normal blood glucose level. For people with diabetes, this typically involves a multilevel management plan involving diet, exercise and medication, notes NIDDK. Diabetics who produce insufficient insulin require insulin replacement therapy. Among diabetics without an insulin deficiency, non-insulin diabetes medications are frequently prescribed to help control blood glucose levels.
References
- National Institute of Diabetes and Digestive and Kidney Diseases: Diagnosis of Diabetes
- National Institute of Diabetes and Digestive and Kidney Diseases: National Diabetes Statistics, 2007
- Centers for Disease Control and Prevention: Leading Causes of Death
- "Harrison's Principles of Internal Medicine, 16th Edition"; Dennis L. Kasper, M.D., et al., Editors; 2004
- "Journal of the American College of Cardiology"; The Pathologic Continuum of Diabetic Vascular Disease; Gabriela Orasanu, M.D., Jorge Plutzky, M.D.; February 2009
